A 6-year old girl with poor physical built presented with gait abnormality, vomiting and recurrent headache since last 15 days. The patient was slightly irritated at the time of presentation. However, there was no history of convulsion or altered sensorium.

The most common site of infarction is the basal ganglia followed by thalamus. Cerebellar infarction is thought to be rare in children. It has been found that infarcts are most common in the posterior inferior cerebellar artery distribution, followed by the superior cerebellar artery and anterior inferior cerebellar artery distribution. Abnormal gait, vertigo, headache, nausea, and vomiting are the presenting symptoms. Causes of stroke in children are many, ranging from intra-cerebral vascular processes like moyamoya, hemoglobinopathies, coagulation disorders e.g. protein C and S deficiencies, leukemia, meningitis, septicaemia, metabolic diseases, iron deficiency anemia, drugs to autoimmune conditions. Trauma in the form of head / cervical injuries or child abuse is also a known cause.